Background: Moral distress (MD) exists when there is a dissonance between what nurses believe are morally correct actions to take on behalf of patients and the actual actions taken. Barriers preventing nurses from acting based on their ethical principles can be intrapersonal, interpersonal, and/or organizational. MD is an important phenomenon associated with outcomes such as staff nurse emotional exhaustion, distancing of self from patients, increased positional turnover, and loss of nurses from the profession. Intensive care units are considered "ground zero" for this phenomenon. Purpose: This empirical systematic review and synthesis focuses on the experience of MD for ICU nurses (ICNs) and has 3 aims: 1. Identify and describe antecedent factors which predispose ICNs to experience moral distress. 2. Ascertain how common the experience of moral distress is for ICNs. 3. Describe nursing responses and nursing actions associated with the experience of moral distress. Theoretical Framework: The research base for MD is predominantly descriptive in nature with small sample sizes and single sites. Metasummary is a philosophical approach to systematic review that allows for the inclusion of studies which are lower on the hierarchy of evidence. Sample: The primary study is the unit of analysis and subjects are the selected number of primary studies. Currently, 261 articles have been identified via electronic search; after screening based on titles and abstracts, 144 remain for further review. Additional searching of reference lists and "gray literature" will be conducted. Method: Using a seven step process, two effect sizes will be calculated: manifest frequency and manifest intensity. A posteriori analysis will be conducted. Results: Preliminary results will be presented, with implications for the foci of nursing. Conclusion: This systematic review will provide preliminary information for future research and the design of evidence-based interventions.

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ICU Nurses' Experience of Moral Distress: A Metasummary of Existing Research

en_GB

dc.identifier.uri

http://hdl.handle.net/10755/159877

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dc.description.abstract

<table><tr><td colspan="2" class="item-title">ICU Nurses' Experience of Moral Distress: A Metasummary of Existing Research</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Barry, Jean, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Grand Valley State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Kirkhof College of Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">301 Michigan St. NE, Grand Rapids, MI, 49503, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">6163315739</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">barryjea@gvsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">J. Barry, C. Leiras-Laubach, J. Tyron, Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI;</td></tr><tr><td colspan="2" class="item-abstract">Background: Moral distress (MD) exists when there is a dissonance between what nurses believe are morally correct actions to take on behalf of patients and the actual actions taken. Barriers preventing nurses from acting based on their ethical principles can be intrapersonal, interpersonal, and/or organizational. MD is an important phenomenon associated with outcomes such as staff nurse emotional exhaustion, distancing of self from patients, increased positional turnover, and loss of nurses from the profession. Intensive care units are considered &quot;ground zero&quot; for this phenomenon. Purpose: This empirical systematic review and synthesis focuses on the experience of MD for ICU nurses (ICNs) and has 3 aims: 1. Identify and describe antecedent factors which predispose ICNs to experience moral distress. 2. Ascertain how common the experience of moral distress is for ICNs. 3. Describe nursing responses and nursing actions associated with the experience of moral distress. Theoretical Framework: The research base for MD is predominantly descriptive in nature with small sample sizes and single sites. Metasummary is a philosophical approach to systematic review that allows for the inclusion of studies which are lower on the hierarchy of evidence. Sample: The primary study is the unit of analysis and subjects are the selected number of primary studies. Currently, 261 articles have been identified via electronic search; after screening based on titles and abstracts, 144 remain for further review. Additional searching of reference lists and &quot;gray literature&quot; will be conducted. Method: Using a seven step process, two effect sizes will be calculated: manifest frequency and manifest intensity. A posteriori analysis will be conducted. Results: Preliminary results will be presented, with implications for the foci of nursing. Conclusion: This systematic review will provide preliminary information for future research and the design of evidence-based interventions.</td></tr></table>

en_GB

dc.date.available

2011-10-26T22:25:05Z

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dc.date.issued

2011-10-17

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dc.date.accessioned

2011-10-26T22:25:05Z

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dc.description.sponsorship

Midwest Nursing Research Society

en_GB

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